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GPs to recruit men to first targeted prostate cancer-screening trial

GPs to recruit men to first targeted prostate cancer-screening trial

The Government has announced a new ‘landmark’ prostate cancer screening trial backed by £42m of funding. 

Due to begin in spring next year, GPs across the UK will be asked to recruit men to participate who are at higher risk of prostate cancer – men aged between 50 and 75, and Black men aged between 45 and 75. 

The trial, developed in partnership with Prostate Cancer UK, will use ‘innovative’ screening methods such as MRI scans, which the Government believes will be ‘more accurate’ than the current blood tests.

Around 10% of men invited to participate will be Black men as their risk of developing prostate cancer is double that of other men.

On average, more than 52,000 men are diagnosed with prostate cancer every year in the UK, and there is currently no official screening programme. 

This new trial, called TRANSFORM, will screen ‘hundreds of thousands of men’ with recruitment by GP practices starting in autumn next year. 

The UK National Screening Committee has welcomed the randomised controlled trial, and will use its evidence to establish if testing strategies like up front MRI scans could ‘tip the balance in favour of a screening programme’.

Earlier this year, the NSC said it will soon consider six different proposals for prostate cancer screening, including a targeted service for men at higher risk. 

There has been no national screening programme as there has not been enough evidence that the benefits would outweigh the risks. 

The NSC has also concluded that the prostate specific antigen (PSA) blood test, which is currently used to help detect the disease, is not accurate enough to identify cancer that needs treatment and could therefore lead to unnecessary tests and treatment.

In its decision to consider proposals for prostate cancer screening, the NSC noted the findings of a recent study which suggested MRI scans may be more accurate in detecting the disease than the PSA test.

Today, chair of the UK NSC Professor Sir Mike Richards said: ‘To make any positive recommendation, the UK NSC would need to see high quality peer-reviewed research that demonstrates that a screening strategy would improve prostate cancer outcomes while minimising serious harms such as overdiagnosis, associated overtreatment and side effects.

‘We have worked with Prostate Cancer UK on the trial design to maximise the chance that it will provide evidence that will help the UK NSC make a recommendation. The committee is very pleased that there is a major focus on getting new evidence in this critical area for men’s health.’

Professor Azeem Majeed, GP and professor of primary care and public health at Imperial College London, told Pulse he thinks a prostate cancer screening trial is ‘important’ as it could help clarify the uncertainties around screening benefits.

He said: ‘There is a lot of pressure from lobby groups to encourage testing for prostate cancer even though there is limited evidence about whether this testing would be a good use of NHS funds and lead to better quality of life and health outcomes for men.

‘A well-designed trial with a large enough sample size and a long follow up can provide data to help answer these questions.’

Prostate Cancer UK will provide £26m for the trial, while the Government has funded £16m via the National Institute of Health and Care Research (NIHR).

Along with this announcement yesterday, on International Men’s Day, the Government also committed to recruiting its first ‘men’s health ambassador’ and to establishing a ‘men’s health task and finish group’.

The group will aim to encourage more men to engage with their health and will focus on men’s access to GP practices and uptake of the NHS health check. 

Health secretary Victoria Atkins said of the screening trial: ‘Our hope is that this funding will help to save the lives of thousands more men through advanced screening methods that can catch prostate cancer as early as possible.’

Prostate Cancer UK chief executive Laura Kerby said it is the ‘most common cancer’ that does not have a national screening programme and ‘it’s about time that changed’.

‘That’s why we’re launching our biggest and most ambitious trial ever. It will finally give us the answers we need to develop a routine testing system and save thousands of men each year,’ she added.

NIHR chief executive Professor Lucy Chappell said: ‘New research into harnessing innovative screening methods is crucial in finding ways to detect this serious disease earlier, in the race against time to save lives.

‘That’s why setting up this landmark new trial in partnership between NIHR and Prostate Cancer UK is so important.

‘Together we can aim to generate high quality long-term evidence to benefit men at risk of developing this condition, and to inform those who plan and deliver NHS services of how best to test for the disease.’ 

In August, a number of GPs – including an NHS England medical director – raised concerns about communication from the Government encouraging men over 50 to check their risk of prostate cancer. 

A post on X (formerly Twitter) identified men at higher risk of the disease and said ‘if that’s you, speak to your GP’.

GPs interpreted this as encouraging unofficial screening for prostate cancer, putting pressure on GPs services.

At the start of this year, a leading UK urologist argued that all men over the age of 50 should go to their GP for a PSA test.


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Please note, only GPs are permitted to add comments to articles

Adam Crowther 20 November, 2023 2:32 pm

Of course massively important but one would hope that GPs and their teams are not forgotten about when resourcing this research 🤔

Dave Haddock 20 November, 2023 9:19 pm

A recent review of cancer screening in JAMA found no evidence that mammography screening for breast cancer prolonged life in women.
Absence of robust evidence did not stop the introduction of breast screening.